Using a Smartphone App to Identify Clinically Relevant Behavior Trends via Symptom Report, Cognition Scores, and Exercise Levels: A Case Series

The use of smartphone apps for research and clinical care in mental health has become increasingly popular, especially within youth mental health. In particular, digital phenotyping, the monitoring of data streams from a smartphone to identify proxies for functional outcomes like steps, sleep, and sociability, is of interest due to the ability to monitor these multiple relevant indications of clinically symptomatic behavior. However, scientific progress in this field has been slow due to high heterogeneity among smartphone apps and lack of reproducibility. In this paper, we discuss how our division utilized a smartphone app to retrospectively identify clinically relevant behaviors in individuals with psychosis by measuring survey scores (symptom report), games (cognition scores), and step count (exercise levels). Further, we present specific cases of individuals and how the relevance of these data streams varied between them. We found that there was high variability between participants and that each individual’s relevant behavior patterns relied heavily on unique data streams. This suggests that digital phenotyping has high potential to augment clinical care, as it could provide an efficient and individualized mechanism of identifying relevant clinical implications even if population-level models are not yet possible.